HomeMy WebLinkAbout1264 PINE AVE; ; CB941331; PermitQXfpu[^
BUILDING PERMIT
10/20/94 15:18
Page 1 of 1
Job Address: 1264 PINE AV Suite:
Permit Type: PLUMBING
Parcel No: Lot#:
Valuation: 0 '
Construction Type: NEW
Occupancy Group: '' Reference#:
Description: LINE FROM WASHER TO SEWER CONN
Permit No: CB941331
Project No: A9401941
Development No:
9223 10/20/94 0001 01 02
C-PRMT 27.00
Status: ISSUED
Applied: 10/20/94
Apr/Issue: 10/20/94
Entered By: DC
Appl/Ownr : SOS ROOTER, INC.
3485 PICKWICK STREET
SAN DIEGO, CA 921g
i
-k-k-x. Fees Required * X *
Fees :
Adjustments:
Total Fees:
Fee description
619 231-6670
2-7.00
ed & Credits
\
* * *
for Plumbing^^^I^^4
27-^^
Enter "Y"
Each Install/Repair |Wa'te
* PLUMBING TOTAL
Tot.c^r^^^^
„,To,t:^ Paymeh<bs^:i
^l^\fA^alance\di-t&i__ \ 27.00
. 00
. 00
INCORPORATED
Ext fee Data
20.00 Y
7 . 00
27 . 00
approval
DATE/C
CLEARANCE
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
ocf 7
PTOMIT «PPUCA-nON
cfty of Carlsbad Building Deparbsent
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
1. mniirnvm —
From List 1 (see back) give code of Pennit-Type:
For Residential Protects Only: From List 2 (see back) give
Code of Structure-Type:
Net LosVGain of Dwelling Units .
2. raOJECT INFORMATION
,1^(^dd
PLAN CHECK NO.
ESr.VAL
PLANaiDHPOSIT_
iVALnXBY
DAIE
FOR OFFICE USE ONLY
ress /
Nearest Cross Streei
Building or Suite No.
LEGAL DESCRIPTION^ Lot No. Subdivision Name/NVimber Unit No.Phase NoT"
CHECK BELUW IL' SUUMl'l'l'Ml):
□ 2 Energy Calcs □ 2 Structural Calcs □ 2 Soils Report □ 1 Addressed Envelope
ASSRSSQRiS-PARCKI KXISTTNC USEDj^CRgnoNioFjy.bRiLll ^ ^ VVc>o\<-PROPOSFD USE
SQ. FT. # OF STORIES3. UJN TALT' PEltaJW (if diHerent trtni dt^tilicant)
# OF BEDROOMS # OF BATHROOMS
NAME (last, name first)ADDRESS
CITY
4. APPUCANT
STATE ZIP CODE
□ AGENT EOR CON'i'KAL'lUR
ADDRESS
DAY TELEPHONE
□ OWNER—□AGENT EOR OWNER□ GONTRAGIUR
NAME (last name first)
jcmL STATE ZIP CODE DAY TELEPHONE
NAME (last name first) j LtAAJ v3)
CITY STATE ZIP CODE
ADDRESS t-E.
DAY TELEPHONE
hi OUVHtAUim -r'^NAME'O^Tiame'first)^^ .O.^
CITY
address 'pVCK-O-iv.CXC ST
ZIP CODE ^"Z-XO'L DAY TELEPHONE \ ^ LoQol OSTATE C-A
STATE UC UCENSE CLASS CITY BUSINESS UC #
name hrstl ADURiKSUESitiNiiK NAME (iast name tust)
CITY STATE ZIP CODE DAY TELEPHONE STATE UC #7. WORKERS'UOaPERSA'HON 3
Workers' Compensation Declaration: 1 hereby aitirm that i have a certihcate ot consent to seil-insure issued by the Director of industnaiRelations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certifiedby the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, lab. C).
INSURANCE COMPANY^py "he:. lO -tzA fe C-& POUCY NO.^J ^IRA'nON DA'TO .A U *^5"Certihcate ot Exemption: i certity that in the performance ot the work tor which this permit is issu^ I shall not employ any person in any maimerso as tobecome supj^ to the Workers' Compensation Laws of Californla^ip.-^''^ -vV ^3"" ®
DATECSIGNATU:
S. OWNER-BUUwner-BuUder Ueclaraaon: 1 nerehy alhrm that 1 am exempt trom the Contractors License law tor the toiiowmg reason:
I, as owner of the property or my employees with wages as their sole compensation, wUl do the work aixl the structure Is not Intended oroffered for sale (Sec. 7044, Business and Professions C^: The Contractor's License Law does not apply to an owner of property who buildsor improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not Intendedor offered for sale. Lf, however, the building or improvement is sold within one year of completion, the owner-builder wiU have the burdenof proving that he did not build or Improve for the purpose of sale.).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and ProfessionsCode: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and contracts for such projectswith contractor(s) licensed pursuant to the Contractor's License law).
I am exempt under Section .Business and Professions Code for this reason:
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter. Improve, demolish, or repairany structure, prior to Its issuance, also requires the applicant for such permit to file a signed statement that he Is licensed pursuant to theprovisions of the Contractor's License Law (Chapter 9, commencing with Section 7000 of Division 3 of the Business and Professions Code)or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permitsubjects the applicant to a dvil penalty of not more than five hundi^ dollars [$500]).
SIGNATURE DATE
GOMPLL'l'E THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLV:
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management andprevention program under Sections 25505, 25533 or 25534 of the Presley-Taimer Hazardous Substance Account Act?
□ YES □ NOIs the appUcant or future building occupant required to obtain a permit from the air pollution control district or air quaUty management district?
□ YES □ NOIs the facility to be constructed within 1,000 feet of the outer boundary of a school site?□ YES □ NOIF ANY OF THE ANSWERS ARE YES, A FINAL CTRTinCATE OF (XIRIPANCY MAY NOT BE ISSUED AFTER JULY 1,1989 UNLESS THE APPLICANTHAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SEHVKiS AND THE AIR POLLUTION OCffnROL IHSIRIcn'.
9. UWUmUUnON LENDING AGRNGY1 hereby attirm that there Is a construction lendmg agency tor the pertormance ot the work tor wtucli this permit is issued (Sec 3097flj UvU Code).
LENDER'S NAME
10. APHLIGANT Uilfill'lGA'HlW
LENDER'S ADDRESS
1 certity tnat i nave read the application and state tliat the above intormahon is correct 1 agree to comply with all City ordlnaiKes and State lawsrelating to building construction. I hereby authorize representatives of the Qty of Carlsbad to enter upon the above mentioned property for Inspectionpurposes. I ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY C» CARLSBAD AGAINST ALL UABUmES, JUDGMENTS, COSTS
AND EXPENSES WmCH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CDNSEQUENCE Cff THE GRANTING OF THIS PERMIT.
OSHA: An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height.
Expiration. Every permit issued hy the Building Official under the provisions of this Code shall expire hy limitation and become nuU and void if thebimding or work authorized by such pCTinlt Is not commmced withm 365 days from the date of such permit or If the building or work authorized bysuch permit is suspended or abandoti^at any time aftia the is commenced for a period of 180 days (Section 303(d) Uniform Building Code),r APPUCl^irrs'SrGNATURE-jr, I // y/ / ^ ^ DATE:' —^^^ PINK: Finance